Abstract

ANTUNEZ PENA, Sergio Antonio et al. Current considerations on the complex incisional hernias. MEDISAN [online]. 2012, vol.16, n.5, pp.753-772. ISSN 1029-3019.

The complex incisional hernias are characterized by a ring wider than 10 cm, with a big sack, the volume of which is bigger than the capacity of the abdominal cavity and when reducing its content, it produces a syndrome of abdominal hypertension with changes of the lung and hemodynamic ventilation, which can result in a compartmental syndrome. Currently its prevention constitutes a challenge for the professionals who carry out this type of surgery, which is aimed at avoiding the complications and at decreasing recurrences. The treatment of the complex incisional hernias requires of the compulsory use of bioprosthesis, carried out by surgeons with deep anatomical and functional knowledge of the abdominal wall and ability of the surgical technique without tension, fixation of the mesh with suture of the same material and the use of prophylactic antibiotic therapy, besides the application of the progressive pneumoperitoneum with a correct preoperative evaluation of these sick persons. The protocolization and classification of these hernias is recommended; and at the same time to carry out multicenter studies for the unification of approaches regarding their diagnosis and treatment both preventive and curative.

Keywords : complex incisional hernia; eventration; ventrocele; laparocele; hernioplasty; herniorrhaphy; bioprosthesis; technique without tension; prevention.

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